Strategic Energy Management Plan - Joe Ciarniello - Vancouver Island Health Authority 2018

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Strategic Energy Management Plan - Joe Ciarniello - Vancouver Island Health Authority 2018
Strategic Energy Management Plan
Vancouver Island Health Authority
2018

Joe Ciarniello
Strategic Energy Management Plan - Joe Ciarniello - Vancouver Island Health Authority 2018
Executive Summary
Island Health is one of six health authorities in British Columbia, Canada. Through a network of hospitals, clinics,
centres, health units, and residential facilities, Island Health provides health care to more than 794,000 people on
Vancouver Island, on the islands of the Georgia Strait, and in mainland communities north of Powell River, and
South of Rivers Inlet. Our health care services include hospital, community and home care. Island Health also
provides environmental and public health services, including education and prevention.

        Facts & Figures:
  Description                                                       Figures
  Annual Operating Budget                                           $2.5 Billion
  Client Population                                                 794,000 (5.1% of which are Indigenous)
  Employees                                                         21,233
  Staff Unions                                                      14
  Physicians and Volunteers                                         1,900 and 6,000 respectively
  Facilities                                                        150+
  Acute Care & Rehabilitation Beds                                  1,555
  Residential Care Beds & Assisted Living Units                     6,426
  Mental Health & Substance Use Beds                                1,110

Island Health is governed by a board of directors, appointed by the provincial government. An executive team
leads the delivery of health service within the Island Health region. We are publicly funded and accountable to
the provincial government and the public for resources used in delivering health care and services. We are also
focused on reducing greenhouse gas (GHG) emissions in an effort to meet the Provincially legislated GHG
reduction target of 40% below 2007 levels by 2030. In fact, this year’s Annual Priorities Plan for Island Health
explicitly states through Objective 4.6 of Goal 4 “Optimizing Health System Value” that we are to reduce Island
Health’s climate impact by implementing projects to reduce our carbon footprint. Inclusion of this objective
ensures and reaffirms our Strategic Energy Management Plan (SEMP) aligns with the organization’s goals.

Island Health’s SEMP for 2018 provides our updated road map for current and future years to ensure we meet our
goals and targets for reduced energy consumption and GHG emissions. Since the last SEMP was issued in 2017,
BC Hydro’s energy conservation focus has altered course to include electrification and FortisBC’s conservation
program has expanded to double incentives available for gas reduction projects, in part as a result of changes in
Provincial and Federal government policy. As our utility companies grapple with these changes, Island Health is
working to capitalize on the new opportunities that arise while remaining focused on the goals of reducing energy
use, utility costs, and greenhouse gas emissions.

Within Island Health challenges to energy management goals include organizational growth, increasing reliance
on energy intensive technology, decreasing incentives from BC Hydro, shrinking capital funds for projects, and
escalating electrical energy rates. In spite of these pressures, Island Health is committed to meeting legislated
carbon emissions reduction targets and reducing operating costs. Progress since the start of the energy
management program in F2008 is illustrated by a 23% reduction in overall energy use intensity (kWh/m2 /year).
Natural gas rates have also dropped 28% over the same period. However, the organization’s size grew by 27.5%
and electricity rates increased 72%. The reduction in energy use intensity and gas prices have significantly
tempered the impact these negative pressures are having on our business.

One of the tools used to enhance our energy management practices is BC Hydro’s Energy Management
Assessment (EMA). The EMA is used to identify weaknesses in the program and guide us to specific action plans

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Strategic Energy Management Plan - Joe Ciarniello - Vancouver Island Health Authority 2018
that will help us address those weaknesses over time. The EMA process helps us ensure we are taking a fulsome
approach to energy management. The five areas of focus identified in the 2018 EMA are: vision and strategy,
organizational integration, target-setting, performance tracking and reporting, and planning discipline. The
specific action items in each of these areas of focus are currently being identified and reviewed with facilities
management to ensure consensus, buy-in, and that they are ultimately achievable over the next two years.

Our key energy targets for this year (short term) remain the same as last year. For electricity, our target is to
implement projects that save at least 1,200,000 kWh/year of electrical energy. For natural gas, our target is to
implement projects that save at least 12,000 GJ/year. We are on track for exceeding both these targets. The
total approved capital budget for the energy conservation projects that will deliver these savings is approximately
$3.0MM.

We are currently working to establish realistic long term organization-wide energy use intensity (EUI) targets as
well as site specific EUI targets. To date, our long term targets have really been driven by and reflected in our
GHG emissions reduction target which is to meet or exceed those set in Provincial legislation. The Carbon Neutral
Action Report provides the overview of how this is being achieved.

In terms of progress to date, Island Health’s energy management program has implemented retrofit projects and
other initiatives since F2008 that have resulted in a cumulative impact of $2,639,128 in avoided annual costs1,
62% of which comes from electrical energy.

In addition to the obvious benefits of avoided costs and mitigating the impact on our budgets of an expanding
organization and increasing electricity rates, the energy management program strives to achieve additional
benefits from its projects. These include improved occupant comfort, reduced maintenance costs, and improved
infrastructure reliability. Examples include improved light quality and substantially reduced maintenance
associated with new LED lights, and new heat recovery systems that harvest waste heat from building exhaust to
offset natural gas, and provide improved cooling for occupants during those hotter than normal summer days.

This strategic plan shows what we are committed to delivering this year in terms of savings and what we hope to
achieve in future years, depending on funding availability. We have already completed numerous energy audits
and compiled a list of potential energy conservation project ideas to draw from. Based on the measures identified
in our studies, we have prepared more than 60 capital requests for funding.

Also inherent in this document is the value received from our partnerships with BC Hydro and FortisBC as they
continue to support Island Health through funding for energy managers, specialists, studies, and most importantly
incentives for project implementation. It’s through these partnerships that we are able to maximize the benefits
of our energy management program. This year, we received the largest ever capital project incentives from BC
Hydro for two new hospitals; a total of $1.7MM. This money will be used to fund the next highest capital project
priority.

    1.   $2,639,128 total = $1,004,087 for natural gas at $8.94/GJ (Table 5) and 112,314 GJ/year (Table 3), plus $1,635,312 for electricity at $0.0843/kWh
         (Table 4) and 19,395,500 kWh/year (Table 4).

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Strategic Energy Management Plan - Joe Ciarniello - Vancouver Island Health Authority 2018
Table of Contents
Executive Summary ............................................................................................................................... 2

Table of Contents .................................................................................................................................. 4

      1. Purpose ..................................................................................................................................... 6

             Key Performance Indicators...................................................................................................... 6

             Organizational Chart................................................................................................................ 8

      2. Multi-Year Plan........................................................................................................................... 9

      3. How Are We Doing? ...................................................................................................................12

             Electrical Energy Savings Booked ............................................................................................. 12

             Natural Gas Energy Savings..................................................................................................... 13

             GHG Emissions and Reduction ................................................................................................ 14

             Electrical Cost Savings............................................................................................................ 15

             Fossil Fuel Cost Savings .......................................................................................................... 17

             Island Health Roll-Up ............................................................................................................. 18

      4. Facility Benchmarks....................................................................................................................20

             Large Acute Care................................................................................................................... 21

             Residential Care.................................................................................................................... 22

             Office/Outpatient Facilities..................................................................................................... 24

             Mental Health ...................................................................................................................... 25

             Health Centre....................................................................................................................... 26

             Laundry Facilities .................................................................................................................. 27

             P3 Performance .................................................................................................................... 28

             Future Island Health Facilities ................................................................................................. 28

             Sites We are Focusing On ....................................................................................................... 29

      5. Energy Studies ...........................................................................................................................30

      6. Awareness and Behaviour Change Program ...................................................................................32

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Strategic Energy Management Plan - Joe Ciarniello - Vancouver Island Health Authority 2018
7. Risks ........................................................................................................................................34

      8. Opportunities ............................................................................................................................35

             Operations ........................................................................................................................... 35

             Capital Projects..................................................................................................................... 37

Senior Management Approval................................................................................................................39

Acknowledgements ..............................................................................................................................40

Appendix A – Policy – Vision, Purpose and Values Statement ......................................................................42

Appendix B - Site Acronyms and Definitions .............................................................................................47

Appendix C - 2018 Energy Management Assessment (EMA) Goals ...............................................................49

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Strategic Energy Management Plan - Joe Ciarniello - Vancouver Island Health Authority 2018
1. Purpose

The Strategic Energy Management Plan (SEMP1 ) is our business plan for reducing energy consumption, utility costs
and greenhouse gas (GHG) emissions. The SEMP sets our objectives and targets for this fiscal year and provides a
realistic plan for achieving them. We can meet our objectives by implementing energy efficiency and conservation
measures in existing and new buildings. The SEMP shows where we are today, where we want to be in the future,
and how we intend to get there. Quarterly reviews of the SEMP will reveal if we are meeting our targets or not. If
not, the Energy Department will work with our stakeholders to adjust the plan.

By looking at actual consumption and cost in Table 6a we can see the net effect on Island Health’s utility budget.
Annual consumption varies depending on energy conservation projects completed in previous years, varying
weather conditions, load creep and costs from changing energy rates and taxes. In F2018 Island Health consumed
104,349,120 kWh of electricity, a 24% increase from the previous year, and 558,202 GJ of Natural Gas, a 2%
increase from the previous year at a total cost increase of 12.2%. The increase in consumption is primarily
attributed to the opening of the new hospitals in Campbell River and Comox.

Though water use has not been a focus of the SEMP, it will be going forward. Consumption was 691,606 m3 in
F2018, a 19.7% decrease from the previous year, at a cost of $1,675,652 (18.2% decrease) so it’s a substantial
piece of our operating budget and needs attention. Plans are evolving and will be reported on in next year’s SEMP.

                                                    Key Performance Indicators

Each year, Island Health’s Energy Department meets with BC Hydro and FortisBC to establish energy reduction
targets. Overarching these targets are the BC Government’s legislated GHG reduction targets for the Province,
enacted through the Greenhouse Gas Reduction Targets Act and the Carbon Neutral Government Regulation.
Savings in electricity and natural gas consumption ultimately reduce GHG emissions, therefore, the SEMP is a key
planning tool used to meet our carbon reduction objectives too.

Our approach to reduced consumption starts with energy studies that identify potential efficiency and
conservation measures and develops the business case for them. The return on investment for these projects is
improved considerably when BC Hydro and FortisBC agree to provide incentives and has typically varied between
14% and 18% in recent years. Energy conservation projects are made up of one or more energy conservation
measures (ECM). After implementation, the calculated ECM savings are “booked” by BC Hydro and FortisBC in
order to measure progress towards meeting targets. Since we have no control over the impacts of weather,
changes in how facilities are used, or increases in service levels, we also measure our success based on avoided
energy use and costs – meaning the difference between the actual consumption and cost and that which we would
have experienced had the measures not been implemented.

1
    The SEMP includes the Energy Department’s EEC Master Project List Excel file.

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Strategic Energy Management Plan - Joe Ciarniello - Vancouver Island Health Authority 2018
There are four key performance indicators we track in order to develop and assess the success of our Strategic
Energy Management Plan, as follows:

          Electricity Savings           These savings are recognized and “booked” by BC Hydro
          Measured in kWh/yr            through one of their energy conservation programs.

          Natural Gas Savings           These are savings that are recognized by FortisBC through
          Measured in GJ/yr             their Energy Specialist and conservation programs.

          Offsettable GHG Emissions     GHG emissions are based on electricity and fossil fuel
          Measured in tCO2 e/yr         consumed at owned & operated facilities, converted into
                                        tonnes of carbon dioxide equivalents (tCO2 e). Emissions from
                                        equipment such as back-up generators and other internal
                                        combustion engines for activities such as landscaping and
                                        fleet vehicles are not included in this SEMP but are included
                                        in the Carbon Neutral Action Report.

          Energy Use Index (EUI)        EUI is the generally accepted measurement of building energy
          Measured in kWh/m2 /year      performance. EUI results are used to help focus efforts on the
                                        worst performing sites and to monitor progress over time.

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Strategic Energy Management Plan - Joe Ciarniello - Vancouver Island Health Authority 2018
Organizational Chart

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Strategic Energy Management Plan - Joe Ciarniello - Vancouver Island Health Authority 2018
2. Multi-Year Plan
Each year, Island Health’s energy team updates the Multi-Year Plan, an integral part of the SEMP, through focused strategic
planning sessions. The Multi-Year Plan identifies electrical and fossil fuel energy savings and resultant carbon reductions
from currently approved capital projects and projects proposed in future years (see Table 1). The Multi-Year Plan evolves
as new and potentially better opportunities are uncovered through energy studies and advances in technology. The Multi-
Year Plan is a component within the Master Project List (MPL), the Excel file at the heart of our program.

  i.    The MPL allows the energy team to keep track of the status of all active and potential projects, and in particular,
        the expected and actual return on investment. This enables the team to identify whether there are sufficient
        projects underway to meet the objectives and targets as discussed in this SEMP. If not, the team uses the MPL to
        revise the plan in order to ensure the stated objectives are met.

  ii.   The MPL is used to capture any and all ideas. Only those that make sense to do at this time make it into the Multi-
        Year Plan. All ideas are retained on the MPL to be evaluated each year should the business case change. This
        ensures we do not lose sight of opportunities and that we have a healthy source of new ones to draw from as
        funding is made available.

 iii.   Budgets shown in Table 1 for the current year have, of course, already been approved. Capital requests have been
        submitted for projects in future years but approval is uncertain at this time. Projects that are approved will be
        identified and funds released at the start of each fiscal year.

 iv.    Projects highlighted in yellow fall into the “low carbon electrification” category and may qualify for current
        Provincial incentives.

        Table 1 Multi-Year Plan

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Strategic Energy Management Plan - Joe Ciarniello - Vancouver Island Health Authority 2018
Fiscal       Program Type                                Project Name                           Booked
Year                                                                                                          Booked       Greenhouse
                                                                                               Electrical
                                                                                                            Natural Gas    Gas Savings   Project Costs [$]
                                                                                                Savings
                                                                                                            Savings [GJ]     [tCO2e]
                                                                                                [GWh]
                BOILER         QAC Main - Upgrade to Near Condensing Boiler                     0.000           298            15        $       325,000
           CON-OPS (BCH+FBC)   NRGH - Phase III Continuous Optimization                         0.492          4,267          218        $       400,000
           CUSTOM (BC Hydro)   VGH - D&T Lighting - BCH$                                        0.231            0             2         $       110,000
           CUSTOM (BCH+FBC)    VGH - Zoning -Phase 2 - LDR - CNCP (FBC$ & BCH$ application)     0.101          1,870           94        $       307,500
                               RJH - B3 Replacement - Feedwater Economizer                      0.000          1,538           77        $        86,250
           CUSTOM (FortisBC)   RJH - Royal/ West Block RB.A1 Targeted Ventilation Scheduling    0.033          1,037           52        $        18,000
                               RJH - Royal/ West Block WB.A1 Targeted Ventilation
 2018/19

                               Scheduling                                                       0.017           613            31        $          5,000
           NEW CONSTRUCTION    NIHP - Additional Electrical Savings "tag-on"                    0.133            0             1         $               -
                               RJH - EMP Cooling Tower Replacement + Pumps                      0.014            0             0         $       320,000
           PROGRAM ENABLED
                               VGH - OR Zoning -Phase 1 - CNCP - FBC$                           0.084          1,299           66        $       307,500
                               GRH - Parking Lot Lighting                                       0.001                          0         $       295,000
                 PSPX
                               QAC Parking Lot Lighting                                         0.001                          0         $        90,000
                               NRGH - Phase 3 Zoning & Scheduling - CNCP                        0.406          3,513          180        $       499,000
             VIHA FUNDED       RJH - Steam Trap Repair                                          0.000          1,187           59        $          9,210
                               DPRC - Electronic Zone Control Upgrade - FBC$ - CNCP             0.047           790            40        $       120,000
                                     2018/19 Total                                              1.561         16,412          835        $     2,892,460
                               CDH - Continuous Optimization - BCH$                             0.068           454            23        $        98,200
                               EPLTC_TLLTC - Continuous Optimization - BCH$                     0.090           109            6         $        75,200
             CON-OPS (BCH)
                               WCGH - Continuous Optimization - BCH$                            0.090           243            13        $        93,000
                               CPRC - Continuous Optimization - BCH$                            0.040           110            6         $        34,000
           CON-OPS (BCH+FBC)   RJH - Phase III Continuous Optimization - Implementation         0.423          4,000          204        $       400,000
                               PRIO - Lighting Upgrade - BCH$                                   0.200                          2         $       170,000
           CUSTOM (BC Hydro)
                               DPRC - Lighting Replacement - BCH$                               0.129            0             1         $        84,000
                               RJH - EMP Return Air Conversion - FBC$ - CNCP                    0.000          3,276          163        $       381,000
           CUSTOM (FortisBC)
                               NRGH - Thermal plant upgrade                                     0.000          7,701          384
                               The Summit @ Quadra Village - Model Savings vs Model
           NEW CONSTRUCTION
                               Baseline                                                         0.633          9,684          490        $       716,900
                               CPRC - Boiler & Domestic Hot Water Systems Upgrade - FBC$
 2019/20

                                                                                                0.000           874            44        $       687,000
                               TLLTC - Electric Boiler Replacement                              1.210            0            -247       $       350,000
                               RJH - D&T Dedicated Heat Recovery Chiller - Option 2             0.000         44,477         2,178       $       996,194
                               RJH - Chiller Plant Eliminate Quasi-Teriary Pumping              0.126                          1         $       175,000
                               CICHC - Heat Pump DHW System - CNCP                              0.000            0             33        $       300,000
                               NRGH - Chiller Systems Optimization Phase 1                      0.760          3,397          178        $     2,284,156
             VIHA FUNDED       TLLTC - Pipe Insulation                                          0.035                          0         $        12,000
                               TGH - Pipe Insulation                                            0.000            0             2         $          7,000
                               WCGH - Pipe Insulation                                           0.000            0             27        $        35,000
                               EPLTC - Pipe Insulation                                          0.000           78             4         $          7,000
                               NRGH - Pipe Insulation                                           0.000          1,430           71        $        70,000
                               WCGH - DHW Preheat System                                        0.000            0             25        $        99,000
                               CPRC - Pipe Insulation                                           0.000           128            6         $          6,000
                                     2019/20 Total                                              3.804         75,961         3,615       $     7,080,650

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Fiscal       Program Type                               Project Name                            Booked
Year                                                                                                          Booked       Greenhouse
                                                                                               Electrical
                                                                                                            Natural Gas    Gas Savings   Project Costs [$]
                                                                                                Savings
                                                                                                            Savings [GJ]     [tCO2e]
                                                                                                [GWh]
                               DARS ECM4.1.1Condensing Boiler Upgrade                           0.000                          18        $       420,250
                BOILER
                               ABH - Boiler Replacement - FBC$                                  0.000           380            19        $       600,000
             CUSTOM (BC        TLLTC - Lighting Upgrade - BCH$                                  0.114            0             1         $        87,691
               Hydro)          GLH - Lighting Upgrade - BCH$                                    0.200            0             2         $       150,000
           CUSTOM (BCH+FBC)    NRGH - Exhaust Air Heat Recovery in Ambulatory Care              0.003           263            13        $        95,000
                 GOAL          Continuous Optimization Round 2 - South Island                   0.154          2,542          128        $       100,000
                               LMH - Control System Modifications                               0.022            0             9         $        99,000
 2020/21

                               OHC - Control Systems Optimzation                                0.050           80             5         $        50,000
                               NRGH - Replace Rehab Chiller with HR and HE Models - CNCP        0.000         14,319          709        $     1,500,000
                               RJH - EMP AHU Replacement                                        0.046          2,630          132        $     2,255,000
             VIHA FUNDED       CLRC - Replace RTUs with HRV and Heat Pumps - CNCP               0.000          1,410           70        $       275,000
                               GLH - Heating Hot Water Upgrade                                  0.015            0             0         $       101,475
                               RJH - Chiller Plant Chilled Water Optimization Phase 2           0.081            0             1         $       128,767
                               WCGH - Heat Pumps for Backup Generator Heating                   0.042            0             0         $        35,000
                               NRGH - Heat Pumps for Backup Generator Heating                   0.105            0             1         $        75,000
                                       2020/21 Total                                            0.832         21,624         1,110       $     5,972,183
             CUSTOM (BC        PHH - Lighting Upgrade - BCH$                                    0.124            0             1         $        99,000
               Hydro)          ABH - Lighting Upgrade - BCH$                                    0.100            0             1         $        70,000
           CUSTOM (FortisBC)   CPRC - Ventilation Upgrades - CNCP                               0.003           697            35        $        70,000
                               YLRS - Perimeter Heating Controls Integration                    0.000            0             3         $        40,000
                               DPRC - Energy Efficiency Upgrades                                0.051           350            18        $        99,000
                               PHH - Energy Efficiency Upgrades                                 0.000            0             10        $        99,000
                               NRGH - Lighting Upgrade in Rehab - BCH$                          0.150            0             2         $        99,000
 2021/22

                               DPRC - Heat Recovery Chiller - CNCP                              0.000          1,350           66        $       490,000
                               CHCC - Replace Main Heating Boilers - FBC$ - CNCP                0.000           563            28        $       637,000
             VIHA FUNDED
                               DPRC - Boiler Room Upgrade - FBC$ - CNCP                         0.000          1,340           67        $       575,000
                               RJH - Royal/ West RB.A1 & WB.A1 Replacement                      0.000            0             0         $       710,496
                               RJH - D&T Cooling Towers Replacement                             0.645                          7         $     1,916,185
                               RJH - Chiller Plant Chilled Water Optimization Phase 3           0.264            0             3         $       380,582
                               RJH - Chiller Plant - AFD for 1000 Ton Chiller Add 24/7 Loads    0.247            0             3         $       212,832
                               NIAB – HVAC System Renewal                                       0.000           50             3         $        78,000
                                       2021/22 Total                                            1.584          4,350          245        $     5,576,095

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3. How Are We Doing?
                                             Electrical Energy Savings Booked

Table 2 shows electrical savings booked with BC Hydro for the past twelve years as well as the projected savings
in the next four years. Energy savings accumulated over time is more indicative of the energy management
program performance, rather than savings achieved in any one year. A graphical representation of our
performance against the target is shown in Figure 1 (below) and demonstrates that Island Health continues to
exceed targeted savings over the long term.

                     Table 2 Booked Electrical and Projected Savings Based on Mulit-Year Plan
                BC Hydro                                                                        BC Hydro
                              Cumulative             Savings             Cumulative Savings                  Cumulative
     Fiscal      Booked                                                                          Target
                                Booked          Achieved/Projected       Achieved/Projected                 Target Savings
     Year       Savings                                                                         Savings
                             Savings [GWh]            [GWh]                    [GWh]                            [GWh]
                 [GWh]                                                                           [GWh]
     F2007       1.722           1.722                1.722                    1.722             1.000           1.000
     F2008       0.886           2.608                0.886                    2.608             1.000           2.000
     F2009       0.767           3.375                0.767                    3.375             1.000           3.000
     F2010       3.798           7.173                3.798                    7.173             2.000           5.000
     F2011       0.581           7.754                0.581                    7.754             2.000           7.000
     F2012       1.890           9.644                1.890                    9.644             2.000           9.000
     F2013       2.750          12.394                2.750                   12.394             1.600          10.600
     F2014       1.613          14.007                1.613                   14.007             1.200          11.800
     F2015       1.602          15.609                1.602                   15.609             1.600          13.400
     F2016       2.280          17.889                2.280                   17.889             1.600          15.000
     F2017       1.506          19.395                1.506                   19.395             1.300          16.300
     F2018       5.098          24.494                5.098                   24.494             1.200          17.500
     F2019                                            1.561                   26.055             1.200          18.700
     F2020                                            3.804                   29.858             1.200          19.900
     F2021                                            0.832                   30.690             1.200          21.100
     F2022                                            1.584                   32.274             1.200          22.300

                           Figure 1 Booked Electrical Savings vs Target F2007 – F2018 [GWh]

35
30                            Impact of making new hospitals more efficient
25
20
15
10
 5
 0
 F2007 F2008 F2009 F2010 F2011 F2012 F2013 F2014 F2015 F2016 F2017 F2018 F2019 F2020 F2021 F2022

              Savings Projected [GWh]        BC Hydro Booked Savings [GWh]       Cumulative Base Target Savings [GWh]

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Natural Gas Energy Savings

Natural gas savings are accounted for by FortisBC through a variety of their conservation programs. Table 3 and
Figure 2 below show savings since F2011 and illustrate performance remains above target.

                 Table 3 Natural Gas Savings Claimed and Projected Based on Mulit-Year Plan
                                                                           Cumulative
                                                       Total Savings
               FortisBC Gas        Cumulative                                Savings        FortisBC Target      Cumulative
 Fiscal Year                                             Achieved/
               Savings [GJ]        Savings [GJ]                             Achieved/             [GJ]           Target [GJ]
                                                       Projected [GJ]
                                                                          Projected [GJ]
   F2007
   F2008
   F2009
   F2010
   F2011           2,206                 2,206             2,206               2,206                                2,206
   F2012          10,171                12,377            10,171              12,377                               12,377
   F2013          14,221                26,598            14,221              26,598                               26,598
   F2014          11,226                37,824            11,226              37,824                               37,824
   F2015          13,048                50,872            13,048              50,872             12,000            49,824
   F2016          18,149                69,021            18,149              69,021             12,000            61,824
   F2017          31,988                101,009           31,988             101,009             12,000            73,824
   F2018          11,305                112,314           11,305             112,314             12,000            85,824
   F2019                                                  16,412             128,726             12,000            97,824
   F2020                                                  75,961             204,687             12,000            109,824
   F2021                                                  21,624             226,311             12,000            121,824
   F2022                                                   4,350             230,661             12,000            133,824

                              Figure 2 Tracked Natural Gas Savings F2011 – F2018 [GJ]

250,000

200,000

150,000

100,000

  50,000

       0
       F2011    F2012      F2013        F2014     F2015      F2016      F2017      F2018     F2019     F2020      F2021        F2022

               Projected Savings [GJ]             Cumulative Target Savings [GJ]           Cumulative Savings Tracked [GJ]

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GHG Emissions and Reduction

Since 2007, the majority of Island Health’s GHG emission reduction has been achieved from capital investment in
energy conservation measures at our owned and operated sites. The heating plants in our buildings provide the
heat to keep occupants warm, produce the hot water for hand washing and steam for sterilization and
humidification. While these are essential, our heating plants consume fossil fuels and produce the lion’s share of
our GHG emissions which contribute to climate change.

As shown below in the graph of Island Health Offsettable GHG Emissions, our conservation efforts have had a
positive impact as emissions have declined since 2009, even as the organization has grown. The red line indicates
the Provincial Emissions Reduction Target and the green line predicts where we will be with our current
aspirational investment level beyond 2017, detailed in the Multi-Year-Plan. As we project into the future, we can
see that it will be a challenge to meet legislated reduction targets.

                                Figure 3 Island Health Offsettable GHG Emissions [tCO 2e]
            Actual Emissions from Buildings                                 Actual and Projected                  Provincial Emissions Target
35,000
                              32,960

                                                32,376

30,000
                                                          31,421
                     30,207

                                       29,697

                                                                   29,325
            28,623

                                                                                                         28,333
                                                                              27,388

25,000
                                                                                                25,609
                                                                                       24,811

20,000

15,000

10,000

 5,000
          2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 2023
                                                                    (Calendar Year)

                                                                                                                                      14 | P a g e
Electrical Cost Savings

Electrical energy savings “booked” with BC Hydro each fiscal year since the current energy management program
started is shown in Table 4 below. For the purpose of determining electrical cost savings, it is assumed that the
impacts of energy projects are not realized until the following year and remain in effect in future years.

To show the value of the energy management program, the table adds the energy savings from all prior years,
shown as Cumulative Savings in Effect. The unit cost of energy is shown in the Blended Cost column and is based
on the total cost of electricity for that year divided by the total energy consumed, inclusive of all charges except
tax. These rates are then used to determine the annual avoided costs in each year as shown in the last two
columns.

Table 4 Avoided Electrical Energy Costs from Capital Projects

                       Savings                         Cumulative                           Annual         Cumulative
                       Booked          Savings in       Savings in       Blended Cost       Avoided         Avoided
   Fiscal Year          (kWh)         Effect (kWh)     Effect (kWh)        ($/kWh)           Costs           Costs
      F2007          1,722,000                                                                                 $0
      F2008           886,000          1,722,000        1,722,000          0.0491          $84,613           $84,613
      F2009           767,000           886,000         2,608,000          0.0524          $136,650         $221,264
      F2010          3,798,000          767,000         3,375,000          0.0568          $191,779         $413,042
      F2011           581,000          3,798,000        7,173,000          0.0574          $412,078         $825,121
      F2012          1,890,000          581,000         7,754,000          0.0611          $473,831        $1,298,952
      F2013          2,750,000         1,890,000        9,644,000          0.0679          $655,262        $1,954,215
      F2014          1,613,000         2,750,000       12,394,000          0.0732          $907,368        $2,861,583
      F2015          1,602,000         1,613,000       14,007,000          0.0763         $1,069,798       $3,931,380
      F2016          2,280,500         1,602,000       15,609,000          0.0800         $1,250,108       $5,181,489
      F2017          1,506,000         2,280,500       17,889,500          0.0833         $1,490,465       $6,671,953
      F2018          5,098,195         1,506,000       19,395,500          0.0843         $1,635,312       $8,307,265

This table shows that the cost of electricity in F2018 would have been $1,635,312 higher if we had no energy
management program in place. It also shows that the cumulative electrical savings of the program since F2008
has reached $8,307,265 in avoided cost. Also, note that the actual rate for electricity has risen from $0.0491/kWh
in F2008 to $0.0843/kWh in F2018 for a substantial 72% increase.

Our electricity bills do not show a year over year reduction in costs reflective of the level of savings shown in Table
4, despite energy management, because of increased rates and total consumption across the organization from
four main factors: increased floor area, increased level of clinical services, increased plug loads, and electrification
(i.e. heat recovery systems). That said, Figure 4 below illustrates where we are today (green line) and where we
would be if we had no energy management program (purple line). The figure also projects where we could be if
we had no increasing demand (load growth) for electricity and still realized all the savings from energy
management (red line).

                                                                                                         15 | P a g e
Figure 4 Impact of Island Health’s Energy Management Program

                                                                                                        we would be here
                                                                                                         without energy
                                                                                                         management

                                                                          avoided energy use
                                                                                                                  we are
                                                                                                                   here

                                                   this is where we could be if
                                                   there was no load growth

The difference between the purple line and green line shows the true impact of the energy management program
and represents energy use avoided. The gap between the green and gray lines is the actual increase observed on
our utility bills. The growth in our electrical load is represented by the gap between the purple line and grey line.
The sudden rise in usage experienced in F2018 was due to two new large hospitals coming on-line while the old
hospitals they replaced were required to remain in operation during the nearly year-long transition period.

                                                                                                      16 | P a g e
Fossil Fuel Cost Savings

Fossil fuel cost savings can be attributed to two main actions: savings resulting from energy efficiency projects
and lower natural gas prices. In general, there are two main factors that drive fossil fuel consumption: weather
patterns and changing floor area. It has been observed that, compared to Environment Canada Climate Normals,
the annual heating degree days (a measure of heat demand due to cold weather) over the past decade can vary
by as much as 10% each year. We can remove the effect of heating degree days (HDD) on our fossil fuel
consumption by normalizing with respect to HDD to determine the real savings on a year-over-year basis (see
“Normalized” columns in Table 5). We can also remove the impact of floor area by dividing consumption and cost
by the floor area (see Normalized GJ/m2 and $/m2 ).

                       Table 5 Actual and Normalized* Fossil Fuel Consumption and Cost

                                                    Weather
                                  Actual          Normalized                    Actual       Weather Normalized
Fiscal        Floor
Year       Area m²          GJ    GJ/m2          GJ     GJ/m2             $       $/m2               $       $/m2

F2008      424,479    548,963       1.29 536,648         1.26    6,810,391       16.04      6,657,365       15.68

F2009      427,525    560,928       1.31 532,296         1.25    7,579,436       17.73      7,199,892       16.84

F2010      430,014    518,986       1.21 529,563         1.23    7,279,093       16.93      7,424,205       17.26

F2011      440,562    561,189       1.27 548,744         1.25    7,597,690       17.25      7,430,486       16.87

F2012      470,811    608,650       1.29 580,781         1.23    8,311,276       17.65      7,928,659       16.84

F2013      470,333    592,632       1.26 575,578         1.22    8,228,505       17.50      7,971,355       16.95

F2014      474,414    581,966       1.23 557,882         1.18    8,510,104       17.94      8,157,128       17.19

F2015      474,679    517,862       1.09 541,237         1.14    6,643,362       14.00      6,938,698       14.62

F2016      474,928    512,552       1.08 512,454         1.08    5,333,512       11.23      5,452,872       11.48

F2017      475,047    545,197       1.15 526,797         1.11    5,296,625       11.15      5,246,130       11.04

F2018      541,259    558,202       1.03 502,446         0.93    4,990,901         9.22     4,630,709         8.56

Overall
%change     27.5↑        1.7↑    20.3↓       6.4↓      26.6↓         26.7↓      42.5↓          30.4↓       45.4↓

This table illustrates total fuel costs, normalized fuel costs, fuel costs per square meter, and weather normalized
fuel costs per square meter trends over the last 11 years. The data illustrates that while Island Health has
increased its floor area by 27.5%, we’ve experienced substantially reduced costs as a result of rates being cut
nearly in half and by keeping overall consumption in check at 2008 levels.

*Normalized figures are adjusted for fluctuations in weather by using a 30 year average of weather data.

                                                                                                     17 | P a g e
Island Health Roll-Up

Tables 6a and 6b show electrical, fossil fuel and total energy consumption and cost for all owned and operated
sites since F2008. Table 6b shows weather adjusted figures which are more indicative of the impact of energy
management since weather effects have been removed. The tables include the organizational-wide Total Energy
Use Index (EUI) based on total energy consumed divided by the total building area of all sites. Since F2008 Island
Health has experienced a drop in EUI from 532kWh/m2 to 409kWh/m2 for a 23% reduction when adjusted for
weather.

                 Table 6a Floor Area, Energy Consumption, Energy Use Index, Cost and Cost Index

                                                                              Total
                                                                           Energy                            Cost
 Fiscal          Floor Area     Electricity      Fossil   Total Energy   Use Index    Total Energy          Index
 Year                  [m²]         [kWh]     Fuel [GJ]          [kWh]   [kWh/m²]            Cost $        [$/m2 ]
 F2008              424,479    76,800,572     548,963     229,290,177          540     10,584,120          $24.93
 F2009              427,525    76,676,733     560,928     232,490,038          544     11,597,039          $27.13
 F2010              430,014    75,124,016     518,986     219,286,918          510     11,547,887          $26.85
 F2011              440,562    77,030,702     561,189     232,916,540          529     12,022,992          $27.29
 F2012              470,811    80,160,999     608,650     249,230,323          529     13,209,753          $28.06
 F2013              470,333    83,969,434     592,632     248,589,559          529     13,933,815          $29.63
 F2014              474,414    84,997,725     581,966     246,654,995          520     14,732,811          $31.05
 F2015              474,679    84,604,701     517,862     228,455,175          481     13,105,125          $27.61
 F2016              474,928    84,706,087     512,552     227,081,757          478     12,117,532          $25.51
 F2017              475,047    83,909,232     545,197     235,352,889          495     12,287,528          $25.87
 F2018              541,259   104,349,120     558,241     259,416,127          479     13,790,753          $25.48

                  Table 6b Weather Adjusted Energy Consumption and Total Energy Use Index

                                                                                              Total Energy Use
   Fiscal Year          Electricity [kWh]       Fossil Fuel [GJ]      Total Energy [kWh]      Index [kWh/m²]
      F2008               76,923,726               536,616               225,984,794                 532
      F2009               76,720,424               532,263               224,572,500                 525
      F2010               74,955,008               529,527               222,047,028                 516
      F2011               77,039,459               548,705               229,458,868                 521
      F2012               80,360,415               580,756               241,682,718                 513
      F2013               83,994,219               575,548               243,870,017                 519
      F2014               84,814,260               557,851               239,774,040                 505
      F2015               84,043,894               541,206               234,380,064                 494
      F2016               84,000,214               512,424               226,341,364                 477
      F2017               83,250,335               526,765               229,575,207                 483
      F2018               81,749,516               502,468               221,324,998                 409

                                                                                                      18 | P a g e
Figure 5 graphically shows the trend of total energy cost compared to EUI (not adjusted for weather). Reduced
natural gas costs yielded significant reductions in overall cost in recent years but the addition of the two new
North Island hospitals in F2018 reversed that trend. Energy use intensity is back on a downward trend.

As Island Health continues to improve and expand service delivery and quality, it’s appetite for energy grows
which just highlights the need to maintain and enhance the energy management program in order to keep costs
in check.

                                       Energy Total - Cost - $                 EUI
        $15,000,000                                                                                  550
        $14,500,000                                                                                  540
        $14,000,000
                                                                                                     530

                                                                                                           EUI (kWh/m2/yr)
        $13,500,000
        $13,000,000                                                                                  520
        $12,500,000                                                                                  510
        $12,000,000                                                                                  500
        $11,500,000
                                                                                                     490
        $11,000,000
        $10,500,000                                                                                  480
        $10,000,000                                                                                  470

                       Figure 5 Trend of Total Energy Cost and Total Energy Use Index

                                                                                                  19 | P a g e
4. Facility Benchmarks

It is important to evaluate building energy performance over time, comparing how each facility performs now
with past performance and how it’s performing relative to other similar facility types within the organization. At
Island Health we prefer to focus on using these internal benchmarks. In other words, we compare ourselves to
our own past performance and strive for year over year reductions at every site.

We have arranged our buildings by facility type, based on their health care purpose, and presented them in terms
of EUI. For each facility type we can see how the EUI has either improved or worsened over the last five years and
compared them to other similar facilities.

The total energy use represents electricity and fossil fuel consumed to meet building needs for heating, cooling,
lighting, ventilation, domestic hot water, clinical functions and process loads. Clinical functions include medical
imaging and laboratories. Process loads include elevators, space humidification, sterilization and food service
kitchens. Backup boiler and generator fuels are not included. (These figures have not been weather corrected.)

                                                                                                     20 | P a g e
Large Acute Care

Large Acute Care have unique requirements and provide the most services. Our Large Acute Care facilities
consume the most energy of all our buildings, accounting for 82% of all consumption, 80% of cost and 65% of all
GHG emissions in F2018.

                                      Table 7 Large Acute Care for F2018

                                             Fossil Fuel   Total Energy         EUI %
               Floor Area     Electricity       Energy       Use Index    Difference   Total Cost       Emissions
Site                 [m²]         [kWh]          [kWh]       [kWh/m²]      vs F2008 Index [$/m²]          [tCO₂e]
CDH               16,498      3,168,461      5,621,913             533       -15.34%         $27            1,043
CRH               16,335      9,512,700      1,869,985             697       -48.15%         $17              354
CBR*              32,316      9,512,700      4,342,618             429            n/a        $28              881
CVH*              39,826     11,420,700      4,547,392             401            n/a        $27              938
NRGH              54,441     13,771,933     19,685,241             615        -9.79%         $32            3,410
RJH              155,304     26,852,359     48,544,580             485        -5.65%         $23            8,459
SPH               14,302      3,246,031      3,990,714             506        -5.82%         $28              751
VGH               49,554      9,164,376     14,729,340             482        -1.82%         $24            2,742
WCGH              14,117      3,721,455      6,761,860             743        -2.24%         $37            1,254

*New Campbell River and Comox Valley hospitals.

                    Figure 6 Large Acute Care F2014 to F2018 EUI Performance (kWh/m2 )

                                                                                                    21 | P a g e
Residential Care

Residential Care facilities are the second highest consumer of energy. These facilities are not as energy intense as
hospitals, focusing instead on providing a home-like environment for residents. Residential Care facilities
represent 12% of our energy consumption, 11% of cost and 13% of our GHG emissions in F2018.

                                        Table 8 Residential Care for F2018

                                              Fossil Fuel   Total Energy           EUI %
                Floor Area     Electricity       Energy            Index     Difference   Total Cost       Emissions
Site                  [m²]         [kWh]          [kWh]       [kWh/m²]        vs F2008 Index [$/m²]          [tCO₂e]
ABH                 9,726      1,123,384      1,381,511              258        -30.74%         $15             260
CHC                 5,328        814,030      1,283,788              394        -22.13%         $22             239
CPRC                3,662        592,979      1,346,455              530        -16.48%         $28             248
DPRC                6,928        740,659      1,584,263              336        -12.26%         $16             292
EPLTC               4,000        524,378      1,303,733              457        -16.99%         $22             240
GLH                 7,609        795,442      1,674,125              325        -26.16%         $16             309
GRH                17,517        999,210      3,518,223              258        -28.51%         $12             642
HSHC                1,600        266,630        264,113              332        -11.50%         $24               50
MTH                 2,629        209,255        983,813              454        -15.80%         $21             179
OBL                14,381      1,316,074      3,771,829              354                        $15             691
PRIO                7,149        839,860      2,105,572              412          0.00%         $21             387
TLLTC               4,651      1,885,205        115,511              430        -15.63%         $25               41
YLRS                5,467        818,562      1,677,625              457        -31.33%         $23             310

                      Figure 7 Residential Care F2014 to F2018 EUI Performance (kWh/m2 )

                                                                                                       22 | P a g e
Small Acute Care
Small Acute facilities are mostly located in and serve rural communities. They represent 2% of our energy
consumption, 4% of cost and 2% of our GHG emissions in F2018.

                                    Table 9 Small Acute Care for F2018

                                          Fossil Fuel   Total Energy         EUI %
               Floor Area   Electricity      Energy            Index   Difference   Total Cost       Emissions
Site                 [m²]       [kWh]         [kWh]       [kWh/m²]      vs F2008 Index [$/m²]          [tCO₂e]
LMH                3,981      734,403     1,189,912              483      -16.18%         $58             270
PHH                4,463    1,684,761       118,954              404      -27.03%         $27               47
PMH                1,176      361,568       470,272              707       20.82%         $92             107
TGH                1,700      285,597       485,651              454       -6.47%         $49             122

                      Figure 8 Small Acute F2014 to F2018 EUI Performance (kWh/m2 )

                                                                                                 23 | P a g e
Office/Outpatient Facilities

These facilities have been grouped together due to their similar usage profiles. Operating typically during weekday
office hours, these facilities consume the least amount of energy within our portfolio. Office/Outpatient facilities
represent 2% of our energy consumption, 2% of cost and 1% of our emissions in F2018.

                                        Table 10 Office/ Outpatient F2018

                                                 Fossil Fuel   Total Energy         EUI %
                   Floor Area     Electricity       Energy            Index   Difference   Total Cost        Emissions
  Site                   [m²]         [kWh]          [kWh]       [kWh/m²]      vs F2008 Index [$/m²]           [tCO₂e]
  BAM                     700        85,089         18,683              148       -6.52%         $20                 5
  BAM-Res                 279        16,368               0              59     -37.38%           $7                 0
  GRHC                    799       128,936               0             161     -44.17%          $20                 1
  NWWS                 1,858         88,906         31,899               65      34.97%           $7                 7
  PAH                     468        75,499               0             161     -22.78%          $21                 1
  PHPCC                   475        75,083               0             158        0.00%         $21                 1
  QAC-Main             8,909        803,118      1,406,956              248       -1.21%         $14              261
  QAC-Pearks           3,905        185,807        534,810              185     -20.18%          $10                98
  VPAHC                1,181        148,011        117,768              225        0.00%         $18                23

                    Figure 9 Office/ Outpatient F2014 to F2018 EUI Performance (kWh/m2 )

                                                                                                     24 | P a g e
Mental Health

These facilities serve a variety of patients who require mental health and substance use services. These facilities
represent 2% of our energy consumption, 2% of cost and 2% of our emissions in F2018.

                                          Table 7 Mental Health F2018

                                                 Fossil Fuel   Total Energy        EUI %
                   Floor Area     Electricity       Energy            Index   Difference   Total Cost       Emissions
  Site                   [m²]         [kWh]          [kWh]       [kWh/m²]      vs F2008 Index [$/m²]          [tCO₂e]
  CLRC                 5,440        622,420      1,157,787              327     -27.59%          $17             214
  DARS                 1,733        170,554        483,575              377     -14.67%          $21               89
  QAC-Ledger           2,772        208,747        360,656              205     -24.86%          $13               67
  SOMH                 3,497        337,929        610,942              271     -22.21%          $17             113

                      Figure 10 Mental Health F2014 to F2018 EUI Performance (kWh/m2 )

                                                                                                     25 | P a g e
Health Centre

These facilities serve patients on a short term, primary care or urgent care basis. Health Centres represent 2% of
our energy consumption, 3% of cost and 2% of our emissions in F2018.

                                             Table 8 Health Centre F2018

                                                Fossil Fuel   Total Energy         EUI %
                Floor Area     Electricity         Energy            Index   Difference   Total Cost       Emissions
Site                  [m²]         [kWh]            [kWh]       [kWh/m²]      vs F2008 Index [$/m²]          [tCO₂e]
CHCC                5,116        864,224        1,824,209              525      -11.18%         $27             337
CICHC               2,129        473,987          625,947              517        1.72%         $65             143
LCHC                3,348        442,218          622,005              318      -43.19%         $21             116
OHC                 3,638        597,228          252,466              234        0.00%         $17               52

                      Figure 11 Health Centre F2014 to F2018 EUI Performance (kWh/m2 )

                                                                                                       26 | P a g e
Laundry Facilities

Laundry facilities are unique because energy use is driven by the amount of laundry processed at these facilities.
There is a small amount of energy used to maintain space comfort. They represent 7.4% of our energy
consumption, 5.8% of cost and 7% of our emissions in F2018.

                                                Table 9 Laundry Facilities F2018

                                                         Fossil Fuel   Total Energy           EUI %
                                       Electricity          Energy            Index      Difference         Total Cost    Emissions
  Site           Laundry [kg]              [kWh]             [kWh]       [kWh/kg]         vs F2008        Index [$/kg]      [tCO₂e]
  CRL              3,180,458            604,894          4,733,343             1.68          -26.54%            $0.06             856
  VGHL             5,975,538           1,851,559         8,817,209             1.79           -8.53%            $0.07        1,603

                    Figure 12 Laundry Facilities F2014 to F2018 EUI Performance (kWh/kg)

                                                                       2.09
                                                                              1.98
                                                                                      1.88
                      1.85

                                                                                                       1.79
                                                                                              1.78
                                                  1.74
                                         1.71

                                                          1.68
                                1.34

                                        CRL                                          VGHL

                                                                                                                   27 | P a g e
P3 Performance

The energy performance of the Patient Care Centre at the Royal Jubilee Hospital is monitored and reported
monthly. The chart below shows that the EUI of the Patient Care Centre has continued to be steady over past
several years. However, in F2018 there was an increase in the building’s energy use due to more occupied floor
area.

                                Figure 13 RJH Patient Care Centre EUI (kWh/m2 )

                                                                                                      554

            452                   453                    455                   463

           F2014                 F2015                  F2016                 F2017                 F2018

Two new public-private-partnership (P3) hospitals were completed and commissioned in F2018 to replace aging
existing hospitals, one in Campbell River and one in Comox, BC. Both facilities were enrolled in BC Hydro’s New
Construction Program and were designed to meet the LEED Gold standard. As a result, these facilities are
expected to perform substantially better than facilities designed to meet the building code minimum. Actual
performance results and more details of these new hospitals will be reported on in the 2019 SEMP.

                                         Future Island Health Facilities

A major new building will be completed in F2020. The Summit @ Quadra Village is a new 320-bed residential care
facility being constructed by the Capital Region Hospital District. Though Island Health will not own the facility,
we will operate and maintain it and pay all utility costs. Having The Summit enrolled in BC Hydro’s New
Construction Whole Building Design Program enabled the energy team to influence design in order to achieve a
high performance building that will use substantially less energy that it otherwise would have.

                                                                                                     28 | P a g e
Sites We are Focusing On

We mainly focus our efforts on our large acute care centres which, in F2018, accounted for 82% of Island Health’s
total energy bill.

Figure 14 Pie Chart of Total Energy Use by Building Type

                                                                                                   29 | P a g e
5. Energy Studies
Table 14 lists energy studies Island Health has completed in F2018 and has underway or in planning stages for
F2019 and F2020. Many of the studies are honing in on specific opportunities or more specialized initiatives. Other
criteria for completing an energy study includes sites that have not had an energy study in the last three to four
years and have a high EUI and/or high total energy use.

On average Island Health invests over $200,000 per year on studies. Historically BC Hydro covered 100% of the
cost of studies that met a broad range of criteria. However, BC Hydro has reduced their funding and scope of
interest down to just funding a maximum of 50% of the cost and limiting scope to lighting and HVAC controls.
Their criteria may change in the next year depending on the direction taken with electrification programs. FortisBC
currently funds 50% of a study that meets specific natural gas reduction criteria. The remaining 50% is paid out
should sufficient measures assessed in the study be implemented. Completion of energy studies is the life blood
of an energy management program and the basis for sound decision making for projects and energy reduction
strategies. Energy studies are also required to apply for Carbon Neutral Capital Program funding from the Ministry
of Health.

                               Table 14 Studies Recently Completed and Planned

  Site and Title                                                                   Cost

  Completed in F2018
  CICHC DHW Heat Pump System Study                                                     $13,500
  TLLTC Eplus Boiler Replacement Options                                               $13,600
  NRGH PIEVC Study                                                                     $80,000
  NRGH Chiller Systems Study                                                           $61,000
  RJH Final Look at D&T Airside Heat Recovery                                          $25,500
  DPRC HVAC controls                                                                    $3,000
  DARS, SOMH, Pandora BC Hydro Energy Study                                            $28,700
  VGH Water Study                                                                       $7,500
  SPH Optimize DHW System                                                               $6,000
  Yucalta Heat Pumps Study                                                             $17,000
  RJH Royal West                                                                       $13,000
  RJH C-Op                                                                            $104,000
  NRGH ICU Climate Change Impact Study                                                  $7,500
  VGH Biomed Envelop Study                                                             $14,500
  EMP Return Air & Heat Recovery Penthouse                                             $12,500
  Total                                                                               $407,300

                                                                                                     30 | P a g e
Proposed or Underway in F2019 and F2020
NRGH Thermal Plant ECM Assessment            $35,000
NRGH Rehab AHU Renewal and ECM Assessment    $60,000
C-Op Round II: EPLTC, TLLTC, CDH, CPRC       $15,000
C-Op Round II: WCGH                          $20,000
VGH AHU Renewal & Optimization               $20,000
Cumberland Laundry Comprehensive Study       $25,000
RJH C-Op (balance of project)                $50,000
VGH DHW System Renewal & Optimization        $25,000
SPH BC Hydro Custom Study                    $15,000
VGH Zoning Phase 3                           $25,000
RJH Water Study                              $20,000
RJH PCC Comprehensive Study                  $45,000
Total                                       $355,000

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6. Awareness and Behaviour Change
Island Health recognizes the role and impact employees have on reducing energy consumption and GHG
emissions. The Energy Department leads the Energy Wise Network Program (EWN) which supports facilities
maintenance and operations staff (FMO) at all owned sites.

Energy Wise Network Program

Building on the success of last year’s EWN campaigns, the year-long Building Energy Challenge Campaign focuses
on FMO staff and includes a series of activities targeting different continuous optimization opportunities. The
intent is to encourage new habits of looking for energy saving opportunities as part of daily rounds.

As a result of the 2017 “fans and pumps” campaign for example, the Victoria General Hospital FMO team identified
substantial energy savings associated with a pair of old heating hot water pumps. New pumps were installed
along with variable speed drives resulting in measureable energy savings along with increased system reliability.

                     Figure 15 - Victoria General Hospital’s new heating hot water pumps.

This year’s training focuses on direct digital controls (DDC) opportunities and promotes best practices and provides
low cost/no cost paths to energy savings. Examples include schedules to turn off equipment when not needed,
reduced heating or increased cooling temperature setpoints after-hours, improved sequences of operations, and
enhanced maintenance procedures.

In an effort to make it easier for FMO staff to implement the concepts promoted in the webinars, checklists have
been developed to help crews identify energy savings opportunities.

FortisBC provided funding in the amount of $10,375 in F2018 to cover the cost of developing and hosting three
webinars. These training webinars encouraged dialogue amoung FMO staff from various locations and were so
well received that the energy team is hosting similar webinars in F2019 with support from both FortisBC and BC

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Hydro.

         Figure 16 Island Health F2018 Building Energy Challenge – Webinar slide

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7. Risks
There are several risks that need to be considered in planning and executing our SEMP, including:

 Persistence – particularly with respect to initiatives such as building re-commissioning and behavioral
  programs; taking steps to ensure energy savings are maintained will be very important to the overall success
  of the energy management program.

 Limits to energy efficiency and conservation – despite the progress made to date upgrading and optimizing
  existing facilities, in order to achieve the longer term GHG reduction targets, Island Health will need to
  implement alternative low/no GHG emissions strategies.

 Capital funding is becoming more difficult to secure. Island Health has explored various options to address
  this including partnering with third parties on construction of low carbon energy plants. This does not appear
  to be an option without Island Health incurring capital debt so alternatives are being explored.

 Reduction in program funding from BC Hydro - energy managers are currently only funded for 50% of their
  salary. Energy studies are only funded to a limit of 50% and Continuous Optimization program funding has
  been reduced to about 15% of what it was. To make matters even more challenging, incentive agreements
  now have an expiry date of under one year. This adds constraints to project planning and further limits the
  type of projects that can be considered.

Risks are being addressed in part by setting aggressive energy and greenhouse gas emission targets for all new
construction projects. Setting targets for existing sites is also being used to mitigate the risks, in particular at sites
that have had extensive energy retrofits. The key going forward will be to ensure that infrastructure renewal,
renovations, and additions to facilities include energy reduction features as part of design.

Behavior change and training of staff will help ensure energy becomes a priority for everyone in Island Health.
Training is helping facility operators monitor energy use performance as well as ensure we only purchase the most
energy efficient products and equipment and capitalize on all available incentive programs.

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8. Opportunities
Fortunately, there are opportunities for saving energy and reducing GHG emissions. Below, we provide an
overview of those we’ve been actively employing or are considering.

                                                   Operations

Recommissioning and Continuous Optimization (C-Op)

Island Health has enrolled 23 facilities in BC Hydro’s Continuous Optimization program (C-Op). Phase I and Phase
II sites have completed implementation and post-implementation verification sessions. For the Phase III sites, VGH
has completed implementation and is now in the coaching phase. NRGH has completed the investigation phase
and is currently implementing measures. RJH is in the investigating phase and will be moving to implementation
in the latter part of F2019. Five sites have been identified and enrolled in the Round 2 program. CDH, CPRC,
EPLTC, and TLLTC will be undergoing a Refresh (i.e. check-in) investigation while WCGH will go through a full
recomissioning.

Recommissioning and continuous optimization are the best strategies to arm operators with because benefits are
achieved without incurring major capital expense. These strategies help ensure we get the most out of our existing
assets and that should always be our first step. It takes diligence, patience, and consistent support to achieve
success. However, once a site has gone through the program, savings often exceed expectations.

                                    Table 15 C-Ops Sites within Island Health

                     Phase I     Queen Alexandra Centre for Children
                                 Saanich Peninsula Hospital
                                 Aberdeen Hospital
                                 Priory Hospital
                                 Ladysmith Community Health Centre
                                 Trillium Lodge1
                                 Eagle Park1
                                 Cowichan District Hospital1
                                 Chemainus Health Care Centre
                                 Cairnsmore Place1
                                 West Coast General Hospital2

                     Phase II    Cowichan Lodge
                                 Lady Minto
                                 Gorge Road Hospital
                                 Glengarry Hospital
                                 Yucalta Lodge
                                 Dufferin Place
                                 Cumberland Health Centre
                                 Port Hardy Hospital
                                 Campbell River Hospital

                     Phase III   Victoria General Hospital
                                 Nanaimo Regional General Hospital
                                 Royal Jubilee Hospital

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Energy Management Information System (EMIS)

Island Health and BC Hydro have invested in the implementation of an EMIS. To date we have 23 sites where
remote monitoring of the main electrical and natural gas utilities is in place.

We have provided training to facilities staff so they can use the tool for regular monitoring and troubleshooting
of energy use anomalies and have developed routine reports and e-mail alerts so facility operators can extract
more useful and timely information from the system. This system is also being used for the implementation of site
specific targets as shown below for WCGH, for example. All sites that have the EMIS system installed have site
specific targets in place.

Unfortunately, BC Hydro has abruptly terminated it’s funding of this EMIS program effective July 1st, 2018. Island
Health is now considering its options.

        Figure 17 Sample Trend from WCGH Showing Baseline, Actual, and Target Elecrtrical Demand

Optimizing Purchasing Decisions

Significant opportunity lies within the purchase of equipment and supplies for Island Health. Deployment of a
policy for smarter purchasing of building equipment that is, for example ENERGY STAR rated, or for furniture and
materials that are healthier will improve indoor air quality and reduce energy use.

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Capital Projects

New Buildings

All new Island Health facilities strive for the highest levels of patient care and lowest energy use. It is our intent
that all new construction and major renovations participate in the BC Hydro New Construction Whole Building
Design Program to model and evaluate building performance before it is built.

Evidence of using a collaborative, integrated design process, like the one fostered by the new construction
program, can be seen in the design of the new North Island hospitals in Comox and Campbell River as well as The
Summit building. Island Health, along with all public sector organizations, has been mandated by the government
to take action on new construction to reduce greenhouse gas emissions; this is indicated in the government’s
2008 Climate Action Plan and the 2016 Climate Leadership Plan. Island Health is required to build all new
construction to the LEED Gold standard. The Province’s 2016 Climate Leadership Plan further mandates a 10 year
emissions reduction plan and a 10 year climate change adaptation plan. To meet those requirements the new
facilities will have to have very low greenhouse gas emissions (i.e. Net Zero) and be adapted for future climate.

Heat Recovery

Heat recovery will continue to be a valuable opportunity in retrofit and new construction projects. By utilizing
heat from building exhaust and other sources and harvesting it with heat pumps for example, we can substantially
lower natural gas consumption and GHG emissions.

Alternative Energy

Solar thermal and solar electric panels have been installed at several Island Health sites. Though costly, these
systems do offset natural gas and purchased electricity and have the potential to provide some level of self
sufficiency.

                                     Figure 18 Solar Electric Panels at WCGH

Island Health has spent several years reviewing the costs and benefits of installing biomass boilers at a handful of
sites. The most favourable economics seems to be at larger facilities due to the economies of scale and boilers
that are more forgiving of variability in fuel quality. In spite of a good business case, it has not been possible yet
to secure funding for a biomas boiler plant in part due to capital funding constraints, as well as, increased risk
associated with quality and reliability of biomass fuel supply.

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